Symptom Profiles Related to Psychotropic Medications in youth at Clinical High-Risk for Psychosis Restricted; Files Only

Abstract

Background:

For individuals at clinical high risk for psychosis (CHR-P), research suggests that baseline antipsychotic use is linked with higher psychosis conversion, but this may be due to   confounding symptom severity with medication. This study examines associations between post-baseline psychotropic medication by CHR-P youth and changes in symptoms at 4-month follow-up.

Methods:

Utilizing data from the North American Prodrome Longitudinal Study 3 (NAPLS-3), we examined symptom severity reduction between baseline and 4-month follow-up among CHR-P youth not on baseline psychotropics. Positive, Negative, Disorganization, and General domains were evaluated using the Scale of Prodromal Symptoms (SOPS). We hypothesized that the initiation of antipsychotics post-baseline would be associated with reduced symptom severity at the follow-up compared to no psychotropic medication. Data analyses included nonparametric and propensity score matching methods to explore symptom trajectories across 3 medication types (antipsychotics, antidepressants, and antipsychotics with other psychotropics).

Results:

The sample included 138 participants in four groups: those receiving antipsychotic medication only (AP, n = 9), antipsychotic with other psychotropic medications (n = 8), antidepressant medication only (n = 17), and a group with no psychotropic medications (n = 104). In the non-parametric test, significant medication group differences were found in positive (χ²(3, 138) = 9.67, p = .022) and general (χ²(3, 138) = 9.3, p = .022) symptoms. Post-hoc tests showed that antidepressants group had less positive symptom reduction compared to the antipsychotic group (Z = 2.48, p = 0.039) and the antipsychotic with another psychotropic medication group (Z = 2.40, p = 0.041. The antipsychotics (Z = -2.23, p = 0.076) and antidepressants group (Z = -2.21, p = 0.068) exhibited a greater decrease in general symptoms compared to no-medication control group.

Conclusions: 

New antipsychotic medication prescription was associated with reductions in symptom severity over time, with variations observed across different symptom domains, underscoring the potential benefits of tailored symptom-specific management strategies in psychiatric care.

Table of Contents

Number of Tables: 7

Number of Figures: 2

Word Count for Abstract: 311

Word Count for Main Text: 10260

About this Honors Thesis

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Emory College
Department	Psychology
Subfield / Discipline	Clinical Psychology
Degree	B.S.
Submission	Honors Thesis
Language	English
Research Field	Psychology, Clinical
Palabra Clave	Antipsychotics Antidepressants Psychotropic Medication Clinical High-Risk for Psychosis
Committee Chair / Thesis Advisor	Elaine Walker, Emory University
Committee Members	David R. Goldsmith, Emory University Abhishek Ananth, Emory University Michael Treadway, Emory University

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